Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
PREPARE FACE/ORAL PROSTHESIS
Pasadena, TX
See all hospitals reporting CPT 21089 →Price type
Pmc Hospital, Llc’s median price of $322 is 6% above the median hospital's median price ($305), higher than 51% of the 1,367 hospitals reporting CPT 21089. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 23 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare medicaid|all other plans case rate · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 2 | UnitedHealthcare medicaid|star case rate · outpatient | $34 | $34 | — | — | — | $34 – $34 |
| 3 | UnitedHealthcare medicaid|starplus case rate · outpatient | $78 | $78 | — | — | — | $78 – $78 |
| 4 | Blue Cross Blue Shield commercial|exchange case rate · outpatient | $153 | $153 | — | — | — | $153 – $153 |
| 5 | Blue Cross Blue Shield commercial|myblue health exchange case rate · outpatient | $195 | $195 | — | — | — | $195 – $195 |
| 6 | Blue Cross Blue Shield medicare|all plans case rate · outpatient | $233 | $233 | — | — | — | $233 – $233 |
| 7 | Cigna Healthspring medicare|all plans case rate · outpatient | $233 | $233 | — | — | — | $233 – $233 |
| 8 | Humana medicare|all plans case rate · outpatient | $233 | $233 | — | — | — | $233 – $233 |
| 9 | Aetna medicare|all plans case rate · outpatient | $237 | $237 | — | — | — | $237 – $237 |
| 10 | UnitedHealthcare medicare|all plans case rate · outpatient | $237 | $237 | — | — | — | $237 – $237 |
| 11 | Blue Cross Blue Shield commercial|blue premier case rate · outpatient | $295 | $295 | — | — | — | $295 – $295 |
| 12 | Ambetter commercial|all plans case rate · outpatient | $349 | $349 | — | — | — | $349 – $349 |
| 13 | Blue Cross Blue Shield commercial|hmo case rate · outpatient | $350 | $350 | — | — | — | $350 – $350 |
| 14 | Blue Cross Blue Shield commercial|ppo case rate · outpatient | $391 | $391 | — | — | — | $391 – $391 |
| 15 | UnitedHealthcare commercial|exchange case rate · outpatient | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 16 | UnitedHealthcare commercial|charter case rate · outpatient | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 17 | UnitedHealthcare commercial|hmo case rate · outpatient | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 18 | UnitedHealthcare commercial|ppo case rate · outpatient | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 19 | Cigna commercial|surefit case rate · outpatient | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 20 | Cigna commercial|hmo case rate · outpatient | $3.6k | $3.6k | — | — | — | $3.6k – $3.6k |
| 21 | Humana commercial|hmo case rate · outpatient | $4k | $4k | — | — | — | $4k – $4k |
| 22 | Humana commercial|ppo case rate · outpatient | $4k | $4k | — | — | — | $4k – $4k |
| 23 | Cigna commercial|ppo case rate · outpatient | $9.2k | $9.2k | — | — | — | $9.2k – $9.2k |
Last updated: Feb 28, 2026
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